Nancy Clark, M.Ed.Director of Medical Informatics Education

Spring 2009 1

http://www.med.fsu.edu/informatics

Objectives

Students will improve their ability to Quickly locate current disease information Answer clinical questions in small group

cases, preceptors Using library subscription resources Using their PDA Using reliable, free resources

Students will improve their ability to Quickly locate current disease information Answer clinical questions in small group

cases, preceptors Using library subscription resources Using their PDA Using reliable, free resources

Spring 2009 2

PPT and Handouts Accessing Medical Information Quickly

(PPT) on Informatics web site under Medical References

Finding Clinical Information Quickly Handout

Decision Support Handout Drug References Handout (on BB)

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When to Use Which Resource? Diagnosis versus list of

complaints/symptoms Zebras versus common problems Detailed information/explanations versus

bottom line Lots of time versus short on time Internet connection versus PDA only

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Types of Clinical Questions

Definition of a term (Stedman’s in PEPID, eMedicine)

Drug question DDx (DxPlain and Epocrates Sx)

Question about a known disease or condition

Lab test question

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Disease Quick References

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Types of Disease Questions BACKGROUND Questions:

Description Cause/etiologyIncidence and prevalence/EpidemiologyICD-9 codesRisk FactorsSigns and SymptomsAssociated ConditionsHistory and physical

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Types of Disease Questions Types of Questions that require current

information:DiagnosisTreatment

○ Surgery, medications, therapy, diet….○ Initial versus ongoing management (follow-up)○ Harm of certain treatments

Prognosis ○ Outcomes or course of the disease

Prevention and screening

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Knowing type of question makes using resources more efficient

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Disease Quick References ACP PIER DynaMed eMedicine Harrison’s Practice PEPID

DynaMed Epocrates Dx 5MCC Harrison’s Practice* PEPID

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WEB PDA

How do the resources differ? Interface issues

Ease of use, organization of subtopics…

Scope of content - # diseases, symptoms Depth of Content

Bulleted lists versus lengthy commentaryLinks out to original research articles

Currency of content Specialty perspective

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PEPID Contains disease information with images

(check out Diverticular Disease) Bottom line bulleted lists Very little background information geared to 3rd

year students or higher Links within to drugs, diagnostic tests,

associated conditions, evidence based summaries

On Web and PDA

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Harrison’s Practice Internal Medicine focus Background information Signs and symptoms as well as diagnoses Moderate depth, scope is growing Linked to Access Medicine content Has drug information from GoldStandard Can be downloaded to PDA

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eMedicine Moderate amount of detail and information Several monographs on one topic by

different specialties One long page (CTRL-F) Background information good Stedman’s is built in Navigation variable between monographs Google searches it

Dynamed

Highly evidence based resource Contains signs and symptoms as well as

diagnosis Very in-depth, thorough Background information as well On PDA as well

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Epocrates Dx on PDA

5 Minute Clinical Consult Content depth light Bottom line resource with background No signs or symptoms Popular- updated annually Scope: 800 diseases

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Compare Resources Background: What is the incidence and

prevalence of acute pancreatitis? Diagnosis: What tests should you order with

Gilberts Disease to confirm diagnosis? Treatment: What are the general treatment

methods for acute otitis media (AOM)? Prognosis: What is the 5 year survival rate

for someone with Stage II adenocarcinoma of the lung?

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Books

Merck Manual available online and free on PDA in Mobile MerckMedicus Access wirelessly on IE: Merck Manual,

Harrison’s Practice, Pocket Guide to Diagnostic Tests, Reuter’s Medical News

Free to all practicing physicians and medical students

ACPMedicine – Scientific American Medicine online

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Mobile Merck Medicus Merck Manual book

Rich, but categories inconsistent between topics

Pocket Guide to Diagnostic Tests Harrison’s Practice

Spring 2009 23Installed on PDA

Mobile Merck Medicus

Spring 2009 24Wirelessly via Internet

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LAB Resources

Epocrates Essentials Labs PDALaboratory tests only

PEPID Lab Manual – online and PDA Pocket Guide to Diagnostic Tests

Laboratory, imaging, and microbiology testsOnline at Access Medicine and

MerckMedicusPDA in Mobile MerckMedicus

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Interpretation of diagnostic tests What are normal lab values? What diseases could cause these

findings? What medications could cause these

findings?

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Epocrates Labs

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PEPID Lab Manual

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Lab tab in Access Medicine Contains

Diagnostic imagingCultureslaboratory

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Lab Questions

1. A basic metabolic panel reveals that a 30 year old man suffering from bipolar disorder has a serum calcium level of 10.9 mg/dL. Is this normal, high or low?

2. A 32 Yr old female patient complaining of fatigue and weight gain is evaluated for hypothyroidism. Her TSH (thyroid stimulating hormone) comes back 0.1 mIU/L. Is this high, low or normal?

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Bottom Line

Pick your favorites that match your taste in depth of information

Learn which resource to use to answer certain types of questions.

Resources should be current, accurate, evidence based, respected.

Resources should be easy to use.

Practice… this is lifelong learning

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